Provider Demographics
NPI:1568162436
Name:DUNLAP, RESSA (CHW)
Entity Type:Individual
Prefix:
First Name:RESSA
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9063 MCGINNIS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-2637
Mailing Address - Country:US
Mailing Address - Phone:971-606-9159
Mailing Address - Fax:
Practice Address - Street 1:9063 MCGINNIS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-2637
Practice Address - Country:US
Practice Address - Phone:971-606-9159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker